MidTerm.docx - Bates Chapter 4 A 54‐year‐
old diplomat...
Bates Chapter 4
A 54‐year‐old diplomat working at the United Nations reports occasional chest pain and
a sense of
tightness in his chest when particularly stressed over work deadlines. The patient is 6
feet 4
inches tall. He has a temperature of 98.6ºF and blood pressure of 140/78. He has a cut
over one
eye that he says is "from shaving."Which of the following represents subjective
information about
this patient?
a) Blood pressure of 140/78
b) Employment at the United Nations
c) Temperature of 98.6ºF
d) Cut over eye from shaving
e) Height of 6 feet 4 inches
d) Cut over eye from shaving
Subjective information is any information that the patient reports but
that is not directly observable or measurable. In this case, the cut is
observable but the manner in which the cut was sustained is not.
Shaving injuries are not usually seen above an eye, so this part of the
patient's report could be explored further. Temperature, blood
pressure, and height are incorrect because these were measured by the
clinician. Employment at the United Nations is incorrect because,
although this was not measured by the clinician, it is a fact that can be
verified objectively.
A physician assistant (PA) has had a long day and has seen many patients. The last
patient of the
day is an 80‐year‐old woman brought to the office by her 35‐year‐old granddaughter.
,MidTerm.docx - Bates Chapter 4 A 54‐year‐
old diplomat...
This is the
patient's first visit to the office. As part of the patient's past history, the PA obtains
information
about childhood illnesses and adult illnesses and then moves on to inquire about the
family
history. Which important area of the past history has she omitted?
a) Allergies
b) Medications
c) Immunizations
d) Chief complaint
e) Social history
c) Immunizations
It is important to understand the three components of the past history:
childhood illnesses, adult illnesses, and health maintenance behaviors
,MidTerm.docx - Bates Chapter 4 A 54‐year‐
old diplomat...
including immunizations and screening tests. Understanding what
conditions the patient is protected against is important for
understanding the possible causes of the present illness. The patient's
chief complaint(s) are, of course, highly significant, but they are not
part of the past history. Allergies and medications also are relevant, but
are part of the present illness, not the past history. Social history is its
own category of investigation.
Upgrade to remove ads
Only $1/month
A 39‐year‐old nurse who is a well‐established patient complains of irregular menstrual
periods and
pelvic pain. She says that she is having trouble sleeping and asks whether she could be
given a
"sleeping pill." The patient also says she is thinking of leaving her job. What is the best
"next
step" in caring for this patient?
a) Ask about recent travel destinations.
b) Obtain a urine sample for testing.
c) Obtain a more complete description of problems.
d) Perform a pelvic examination.
e) Obtain blood for testing.
c) Obtain a more complete description of problems.
It is critical to thoroughly understand the patient's problem in order to
narrow the focus of the examination. This is particularly true when
symptoms are reported in multiple body systems, as in this case. To the
extent possible, the seven attributes of each symptom should be
explored. Although it may be necessary to perform a pelvic
examination, the exam will yield more information if the clinician has
determined, for example, the patient's pregnancy history. The clinician
may need to obtain a urine sample for testing later but should have a
possible diagnosis in mind when doing so. A similar argument applies
regarding obtaining blood for testing—testing for what? Recent travel
destinations should be elicited if there is a suspicion that an infectious
agent was acquired somewhere else, but more information is needed to
determine whether this would be a realistic suspicion.
, MidTerm.docx - Bates Chapter 4 A 54‐year‐
old diplomat...
One important examination technique involves using the third fingers of each hand to
determine
the health of internal organs. What is the name of this technique?
a) Inspection
b) Listening
c) Auscultation
d) Percussion
e) Palpation
d) Percussion
Percussion involves striking the middle finger of one hand against the
middle finger of the other, with the latter laid on the skin of the chest
old diplomat...
Bates Chapter 4
A 54‐year‐old diplomat working at the United Nations reports occasional chest pain and
a sense of
tightness in his chest when particularly stressed over work deadlines. The patient is 6
feet 4
inches tall. He has a temperature of 98.6ºF and blood pressure of 140/78. He has a cut
over one
eye that he says is "from shaving."Which of the following represents subjective
information about
this patient?
a) Blood pressure of 140/78
b) Employment at the United Nations
c) Temperature of 98.6ºF
d) Cut over eye from shaving
e) Height of 6 feet 4 inches
d) Cut over eye from shaving
Subjective information is any information that the patient reports but
that is not directly observable or measurable. In this case, the cut is
observable but the manner in which the cut was sustained is not.
Shaving injuries are not usually seen above an eye, so this part of the
patient's report could be explored further. Temperature, blood
pressure, and height are incorrect because these were measured by the
clinician. Employment at the United Nations is incorrect because,
although this was not measured by the clinician, it is a fact that can be
verified objectively.
A physician assistant (PA) has had a long day and has seen many patients. The last
patient of the
day is an 80‐year‐old woman brought to the office by her 35‐year‐old granddaughter.
,MidTerm.docx - Bates Chapter 4 A 54‐year‐
old diplomat...
This is the
patient's first visit to the office. As part of the patient's past history, the PA obtains
information
about childhood illnesses and adult illnesses and then moves on to inquire about the
family
history. Which important area of the past history has she omitted?
a) Allergies
b) Medications
c) Immunizations
d) Chief complaint
e) Social history
c) Immunizations
It is important to understand the three components of the past history:
childhood illnesses, adult illnesses, and health maintenance behaviors
,MidTerm.docx - Bates Chapter 4 A 54‐year‐
old diplomat...
including immunizations and screening tests. Understanding what
conditions the patient is protected against is important for
understanding the possible causes of the present illness. The patient's
chief complaint(s) are, of course, highly significant, but they are not
part of the past history. Allergies and medications also are relevant, but
are part of the present illness, not the past history. Social history is its
own category of investigation.
Upgrade to remove ads
Only $1/month
A 39‐year‐old nurse who is a well‐established patient complains of irregular menstrual
periods and
pelvic pain. She says that she is having trouble sleeping and asks whether she could be
given a
"sleeping pill." The patient also says she is thinking of leaving her job. What is the best
"next
step" in caring for this patient?
a) Ask about recent travel destinations.
b) Obtain a urine sample for testing.
c) Obtain a more complete description of problems.
d) Perform a pelvic examination.
e) Obtain blood for testing.
c) Obtain a more complete description of problems.
It is critical to thoroughly understand the patient's problem in order to
narrow the focus of the examination. This is particularly true when
symptoms are reported in multiple body systems, as in this case. To the
extent possible, the seven attributes of each symptom should be
explored. Although it may be necessary to perform a pelvic
examination, the exam will yield more information if the clinician has
determined, for example, the patient's pregnancy history. The clinician
may need to obtain a urine sample for testing later but should have a
possible diagnosis in mind when doing so. A similar argument applies
regarding obtaining blood for testing—testing for what? Recent travel
destinations should be elicited if there is a suspicion that an infectious
agent was acquired somewhere else, but more information is needed to
determine whether this would be a realistic suspicion.
, MidTerm.docx - Bates Chapter 4 A 54‐year‐
old diplomat...
One important examination technique involves using the third fingers of each hand to
determine
the health of internal organs. What is the name of this technique?
a) Inspection
b) Listening
c) Auscultation
d) Percussion
e) Palpation
d) Percussion
Percussion involves striking the middle finger of one hand against the
middle finger of the other, with the latter laid on the skin of the chest
